How to read this page. Field citations describe the wider literature. They motivate early-intervention research. They are not evidence that NWPT-SM32300 prevents psychosis or has established CHR-P efficacy. This page is not medical advice and not an investment offer.

CHR-P — what it means (and what it does not)

CHR-P (sometimes called ultra-high risk or an at-risk mental state) typically involves help-seeking and one or more of: attenuated (subthreshold) psychotic symptoms; brief limited intermittent psychotic symptoms; or a combination of vulnerability markers with recent functional decline — assessed with structured instruments such as CAARMS or SIPS-class interviews.1

  • Elevated risk is real at the group level. Individual outcomes vary widely.
  • A risk label is not destiny. Most people identified as CHR-P do not develop a psychotic disorder within typical short- to medium-term follow-up windows.
  • Experiences may affect education, friendships and family relationships, and steps toward independence — through distress, sleep disruption, anxiety or depression, or time spent seeking help — without implying that someone is “becoming schizophrenic.”
  • Comorbid anxiety, depression and substance-use problems are common and deserve treatment in their own right.

This site does not diagnose, enrol participants, or replace specialist care.

Risk figures — prevalence and transition

Prevalence (how common the CHR-P state is when systematically assessed) is not the same as transition risk (the chance of developing a full psychotic episode over follow-up in people already identified as CHR-P).

The 2021 update is the primary modern source. Its pooled estimate gives the one-in-four summary above. Its separate Kaplan–Meier series, and the older 2012 pooled averages, are in Method notes.

Current care

In UK NICE guidance, people with transient or attenuated psychotic symptoms or other presentations suggestive of possible psychosis should be referred without delay for specialist assessment (for example CAMHS, early intervention in psychosis services, or specialist mental-health assessment depending on age and pathway).56

For symptoms not sufficient for a diagnosis of psychosis or schizophrenia, NICE recommends considering individual cognitive behavioural therapy (CBT), with or without family intervention, and offering treatments for coexisting conditions such as anxiety, depression or substance misuse. Regular monitoring of symptoms and functioning for up to about three years is described when a clear psychosis diagnosis cannot be made.

These are care standards for distress and risk management — not proof that any one intervention prevents all transitions.

Official guidance: NICE CG155 · NICE CG178

Research gap

Antipsychotic medicines are important in the treatment of established / first-episode psychosis, typically alongside psychological interventions, under specialist pathways.

For people considered at increased risk of psychosis — or for mental-state changes that are not sufficient for a psychosis diagnosis — NICE states that antipsychotic medication should not be offered with the aim of decreasing the risk of, or preventing, psychosis (and should not be offered for those insufficient symptoms alone).

We do not make an exhaustive global claim that “no product is licensed anywhere.” From verified guidance and recent evidence synthesis:

  • In the NICE frameworks cited here, antipsychotics are not recommended as preventive treatment for the at-risk group.
  • A 2025 updated meta-analysis by the World Psychiatric Association Preventive Psychiatry section (24 RCTs; 3,236 CHR-P participants) found no sustained, robust effect of the investigated active interventions — including antipsychotics and CBT at key early time points — on preventing transition compared with controls, and highlighted the need for novel approaches and better stratification.7

That combination — guideline restraint on antipsychotics for prevention, plus unsettled RCT evidence for existing preventive packages — is the research gap this programme sits beside. It is not evidence that any specific candidate works.

Wider impact

When young people struggle with attenuated symptoms, anxiety, depression or disrupted schooling, the harms are not only clinical. Education interrupted, delayed employment, strained family carers and reduced independence all carry human and economic weight.

  • Cost-effectiveness asks whether an intervention’s health gains are worth its costs relative to alternatives (a health-economics question for future, evidence-based appraisal).
  • Cost savings claims require verified offsets (for example reduced hospitalisation). Macro model outputs are not the same as proven savings from any one product.
  • Macro mental-health estimates (whole-system) must stay separate from NWPharmaTech programme outcomes and from any investor-return narrative.

MACRO only (not NWPT). The McKinsey Health Institute’s 2025 public report Investing in the future: How better mental health benefits everyone estimates that scaling effective mental-health interventions could unlock up to about US$4.4 trillion in global GDP by 2050, with whole-system modelled economic gains on the order of US$5–$6 per dollar invested (MACRO estimates — not investor returns for this programme).9 Those figures are global brain-health / mental-health modelling. They are not CHR-P-specific. They are not outcomes delivered by NWPT-SM32300. They are whole-system modelled estimates only — not financing claims for this programme, and not evidence that NWPT-SM32300 delivers those gains.

RAISE — care after a first episode (not CHR-P prevention)

Do not confuse two different questions:

QuestionEvidence status (high level)
Can coordinated specialty care improve outcomes after a first episode of psychosis? Supported by programmes such as RAISE / NAVIGATE
Can a medicine prevent transition from CHR-P to psychosis? Still largely unanswered; recent prevention metas remain cautious

The NIMH RAISE Early Treatment Program compared NAVIGATE coordinated specialty care with usual community care in 404 people with first-episode psychosis across 34 US clinics. Over two years, NAVIGATE participants stayed in treatment longer and showed greater improvement in quality of life, symptoms, interpersonal relationships and involvement in work or school; benefits were greater when the duration of untreated psychosis was shorter (study median split 74 weeks).8

RAISE speaks to care after onset. It does not answer whether a specific medicine prevents psychosis in people who are still at clinical high risk.

How the proposed Phase 2B sits beside part of the research gap

Candidate: NWPT-SM32300 — investigational 300 mg CBD micellar-emulsion softgel.

Proposed Phase 2B aims (high level; study initiation subject to funding, finalisation and applicable approvals):10

  • Evaluate dose response, symptoms, safety and tolerability
  • Approximately 328 participants
  • Randomised to placebo or one of three daily doses (300 / 600 / 900 mg)
  • 12 weeks treatment, with follow-up at week 16

Effectiveness in this population has not been established. Prevention or delay of transition is not presented as the current primary aim. Findings from other CBD products or other populations are not results for NWPT-SM32300. This page does not publish BA/PK numbers or unpublished clinical study report figures.

Field unmet need and positive RAISE evidence for post-onset care do not prove that this candidate works.

Method notes & references

Prevalence vs transition. Prevalence answers “how common is the CHR-P state when assessed?” Transition answers “among people already identified as CHR-P, what proportion develop psychosis over follow-up?” Those are different questions, so the numbers are not interchangeable.

The 2021 pooled and Kaplan–Meier estimates. Salazar de Pablo et al., 2021 (JAMA Psychiatry) reported two analyses. The pooled estimate at 3 years was 25%, the one-in-four figure above. Separately, their Kaplan–Meier cumulative estimates were 8% at 6 months, 14% at 1 year, 20% at 2 years, 27% at 3 years and 35% at 10 years. The two analyses use different methods, so their figures are not combined into one series; between-study heterogeneity was high.4

An older synthesis (Fusar-Poli et al., 2012) reported pooled transition risk of about 18% at 6 months, 22% at 1 year, 29% at 2 years and 36% at 3 years across 27 studies (n = 2,502; literature to January 2011; mean follow-up ~31 months).3 Those older pooled averages are historical context only. They come from an earlier, separate synthesis and are kept apart from the 2021 figures on this page.

Neither set is a personal prognosis. Neither is a result for NWPT-SM32300.

Footnotes

  1. Yung AR, Yuen HP, McGorry PD, et al. Mapping the onset of psychosis: the Comprehensive Assessment of At-Risk Mental States. Aust N Z J Psychiatry. 2005;39(11-12):964-971. doi:10.1080/j.1440-1614.2005.01714.x ↩
  2. Salazar de Pablo G, Woods SW, Drymonitou G, de Diego H, Fusar-Poli P. Prevalence of Individuals at Clinical High-Risk of Psychosis in the General Population and Clinical Samples: Systematic Review and Meta-Analysis. Brain Sci. 2021;11(11):1544. doi:10.3390/brainsci11111544 ↩
  3. Fusar-Poli P, Bonoldi I, Yung AR, et al. Predicting Psychosis: Meta-analysis of Transition Outcomes in Individuals at High Clinical Risk. Arch Gen Psychiatry. 2012;69(3):220-229. doi:10.1001/archgenpsychiatry.2011.1472 ↩
  4. Salazar de Pablo G, Radua J, Pereira J, et al. Probability of Transition to Psychosis in Individuals at Clinical High Risk: An Updated Meta-analysis. JAMA Psychiatry. 2021;78(9):970-978. doi:10.1001/jamapsychiatry.2021.0830 ↩
  5. NICE CG155. Psychosis and schizophrenia in children and young people: recognition and management. Recommendations 1.2.1–1.2.6, including 1.2.6. nice.org.uk/guidance/cg155 ↩
  6. NICE CG178. Psychosis and schizophrenia in adults: prevention and management. Recommendations 1.2.1.1–1.2.3.2, including 1.2.3.2. nice.org.uk/guidance/cg178 ↩
  7. Minichino A, Davies C, Karpenko O, et al. Preventing psychosis in people at clinical high risk: an updated meta-analysis by the World Psychiatric Association Preventive Psychiatry section. Mol Psychiatry. 2025. doi:10.1038/s41380-025-02902-8 · 24 RCTs, n = 3,236 CHR-P ↩
  8. Kane JM, Robinson DG, Schooler NR, et al. Comprehensive Versus Usual Community Care for First-Episode Psychosis: 2-Year Outcomes From the NIMH RAISE Early Treatment Program. Am J Psychiatry. 2016;173(4):362-372. See also NIMH: Team-based Treatment is Better for First Episode Psychosis ↩
  9. McKinsey Health Institute. Investing in the future: How better mental health benefits everyone (2025). mckinsey.com/mhi/… · MACRO · not NWPT · not investor returns ↩
  10. NWPharmaTech programme description (public update What this programme aims to establish). Proposed / investigational. Effectiveness not established. ↩

What visitors can do

This is not a diagnosis service, crisis line, trial enrolment portal, or investment channel. If you or someone you care for is in crisis, use local emergency or specialist mental-health services.